CPT® Code 0746T

1. Indications

The procedure of cardiac focal ablation utilizing radiation therapy for arrhythmia is indicated for patients experiencing specific types of heart arrhythmias. The following conditions are explicitly recognized as indications for this procedure:

• Ventricular Tachycardia (VT) - A rapid heart rhythm originating from the ventricles, which can lead to serious complications if not managed effectively.

2. Procedure

The procedure for cardiac focal ablation utilizing radiation therapy for arrhythmia involves several critical steps to ensure accurate treatment delivery. Each step is designed to optimize the effectiveness of the ablation while minimizing risks to surrounding tissues.

• Step 1: Patient Assessment and Mapping - Initially, the radiation oncologist conducts a comprehensive assessment of the patient’s cardiac condition. This includes identifying the specific anatomical and electrical locations of the arrhythmia. The mapping process is crucial as it delineates the arrhythmia site (nidus) and highlights areas that should be avoided during treatment to protect healthy tissue.
• Step 2: Data Input into Targeting Software - Once the mapping is complete, the gathered data is input into specialized arrhythmia targeting software. This software is designed to assist in the creation of a multidimensional radiation treatment plan by integrating the anatomical and electrical information obtained during the mapping phase.
• Step 3: Treatment Planning - The treatment planning system utilizes the information from the targeting software to develop a detailed plan. The radiation oncologist reviews this plan, focusing on managing cardiac and lung motion, delineating the target treatment volume, and establishing the planned radiation dose distribution. This step is critical for ensuring that the radiation is delivered accurately to the target area while minimizing exposure to surrounding organs.
• Step 4: Final Review and Optimization - After the initial treatment plan is developed, a final review is conducted to ensure all parameters meet the necessary goals for both the target and surrounding organs. The plan is optimized to confirm that the radiation will be delivered at the planned dose distribution, ensuring the highest likelihood of successful treatment outcomes.

3. Post-Procedure

Post-procedure care following cardiac focal ablation utilizing radiation therapy for arrhythmia typically involves monitoring the patient for any immediate side effects or complications. Patients may require follow-up appointments to assess the effectiveness of the treatment and to monitor for any recurrence of arrhythmias. Additionally, the healthcare team may provide guidance on lifestyle modifications and ongoing management strategies to support the patient's cardiac health. It is essential for patients to adhere to follow-up schedules and report any unusual symptoms to their healthcare provider promptly.